The Herbalist: Nicholas Culpeper and the Fight for Medical Freedom

(#litres_trial_promo) The plaster was removed. However, later in the evening it was put back, whereupon the King started ‘panting, raving’, and his pulse became irregular. The following day, Tuesday, he went into dangerous decline, and it began to dawn on his medical team that the illness might prove fatal. He was given a soothing drink or ‘posset’ made with gillyflower together with some of the same syrup used to impregnate the plaster, but he complained that it made him ‘burn and roast’. Despite this, he apparently asked for more. Harvey left for London, perhaps to brief officials there. On the road he met John Williams, Bishop of Lincoln and recently made Lord Keeper of the Great Seal, the seal used to ratify documents of state. Harvey informed Williams of the King’s grave state.

On Wednesday night, James suffered another violent fit. Blood was let in the hope of bringing relief. On Friday the plaster was apparently applied again, and in the evening another symptom reportedly appeared: his tongue swelled up to such a size that he could no longer speak clearly. On Saturday the physicians held a crisis meeting, but could not agree on the nature of the King’s illness or how to proceed. The following day, James died.

(#litres_trial_promo)

Within forty-eight hours, his body was back in London and subjected to a post-mortem. A witness described the procedure:

The King’s body was about the 29th of March disbowelled, and his heart was found to be great but soft, his liver fresh as a young man’s; one of his kidneys very good, but the other shrunk so little as they could hardly find yt, wherein there was two stones; his lights [lungs] and gall black, judged to proceed of melancholy; the semyture of his head [skull] so strong as that they could hardly break it open with a chisel and a saw, and so full of brains as they could not, upon the opening, keep them from spilling, a great mark of his infinite judgement. His bowels were presently put into a leaden vessel and buried; his body embalmed.

(#litres_trial_promo)

The autopsy confirmed the King’s known problems with recurring urinary infections, kidney stones, and, as the blackened lungs and gall particularly indicated, the predominance of melancholia in his complexion. The surplus of grey matter that burst out of his brain case also provided the King’s subjects with reassuring physiological evidence of his intelligence. But nothing was revealed about the cause of death. Rumours soon began to circulate that he had been poisoned.

Such suspicions were stimulated by widespread anxieties about the state of the court. Many believed it had become rife with corruption and Catholicism, nurtured by James’s favouritism. One man more than any other was seen as the embodiment of such concerns: George Villiers, James’s favourite, whispered to be his lover, ‘raised from the bottom of Fortune’s wheel to the top’.

(#litres_trial_promo) Villiers had benefited more than anyone else from royal favours. The son of a sheriff and a ‘servant woman’, Villiers had been elevated by James to Duke of Buckingham in 1623. The last duke in England had been Thomas Howard, Duke of Norfolk, executed in 1572 for his plan to marry Mary Queen of Scots and found a Catholic dynasty to replace Elizabeth’s. Elizabeth, as parsimonious with titles as James was extravagant, and disturbed by having to order the execution of a close kinsman, had thenceforth refused to raise even her closest favourites to a rank traditionally reserved for those with royal blood, and now tainted with treasonous associations.

Such a high position provided the perfect stage for Villiers to play out his political ambitions, which now included arranging the future of James’s son and heir, Prince Charles. The sickly, shy, stammering prince was initially jealous of Villiers’ closeness to the King. When he was sixteen, he had lost one of Villiers’ rings, prompting James to summon his son and use ‘such bitter language to him as forced His Highness to shed tears’. A few months later, during a walk in Greenwich Park, James boxed the boy’s ears for squirting water from a fountain into Villiers’ face.

(#litres_trial_promo) But by the later years of James’s reign, loyalties began to shift. Villiers began to lavish his attentions on Charles, who responded by declaring himself Villiers’ ‘true, constant, loving friend’, trusted enough to take charge of his marriage negotiations. Villiers promoted matches first with the Infanta Maria, the daughter of the King of Spain, then Henrietta Maria of France, both Catholic royals. The Puritans, a body with growing influence in the House of Commons, sensed danger, which intensified in May 1625, just two months after Charles had succeeded to the throne, when he married Henrietta Maria by proxy (she was still in France at that stage, Villiers having been dispatched immediately after James’s funeral to fetch her). Fears spread that with her arrival would come a Catholic dispensation and, as the MP John Pym put it melodramatically: ‘If the papists once obtain a connivance, they will press for a toleration; from thence to an equality; from an equality to a superiority; from a superiority to an extirpation of all contrary religions.’

(#litres_trial_promo) Thus, when the charges that James had been poisoned first emerged, there were many ready to identify Villiers as the chief suspect, working to hasten the succession of his new best friend.

Suspicions were first voiced by John Craig. Being a Scottish doctor, he had initially practised in London without a licence but had agreed to submit himself to examination by the College of Physicians, appearing before the Censors on 2 April 1604 alongside Harvey, who was receiving his second examination that day. Unlike Harvey, Craig was admitted immediately, despite being a Scot and therefore according to the College’s own statutes ineligible for membership. Craig had very little to do with the College thereafter, devoting himself almost exclusively to the King.

It was in the early days of James’s final illness that Craig’s suspicions were aroused. Villiers’ mother, the Countess of Buckingham, had taken it upon herself to nurse the King, and, Craig claimed, it was she who first applied a plaster to the King’s stomach without the permission of James’s attending physicians. Her intervention ‘occasioned so much discontent in Dr Craig, that he uttered some plain speeches, for which he was commanded out of court’. He was escorted from Theobalds and banned from returning to James’s side, and from further contact with Charles.

(#litres_trial_promo) Soon after, he accused the Countess and her son the Duke of poisoning the King.

Aspects of Craig’s story were confirmed by others who were present in the ‘Chamber of Sorrows’. Thomas Erskine, Earl of Kellie, a Villiers supporter who was at Theobalds throughout, wrote in a letter dated 22 March 1625 to his kinsman John Erskine, Earl of Mar: ‘There is something fallen out here much disliked, and I for myself think much mistaken, and that is this. My Lord of Buckingham, wishing much the King’s health caused a plaster to be applied to the King’s breast, after which his Majesty was extremely sick, and with all did give him a drink or syrup to drink; and this was done without the consent or knowledge of any of the doctors; which has spread such a business here and discontent as you would wonder.’

(#litres_trial_promo)

The accusation became public some months later in a pamphlet by George Eglisham (or Eglington), doctor to James Hamilton, the Earl of Abercorn. Eglisham also claimed to have treated the King on various occasions over the previous ten years. He was not apparently in attendance during the King’s final days, though he may have been at Theobalds in mid-March. He alleged that Villiers, having seen that ‘the King’s mind was beginning to alter towards him’, decided it was time for James to ‘be at rest’ so his son could inherit. When the King fell sick ‘of a certain ague, and in that spring [infection], was of itself never found deadly, the Duke took his opportunity when all the king’s Doctors of Physic were at dinner, upon the Monday before the King died, without their knowledge and consent, offered him a white powder to take: the which he a long time refused; but overcome with his flattering importunity at length took it in wine, and immediately became worse and worse, falling into many swoonings and pains, and violent fluxes of the belly so tormented, that his Majesty cried out aloud of this white powder, would to God I had never taken it, it will cost me my life’. The following Friday, Villiers’ mother was involved in ‘applying a plaster to the King’s heart and breast, whereupon he grew faint, short breathed, and in a great agony’. The smell of the plaster attracted the attention of the physicians, who, returning to the King’s chamber, found ‘something to be about him hurtful unto him and searched what it should be, found it out, and exclaimed that the King was poisoned’. Buckingham himself then intervened, threatening all the physicians with exile from the court ‘if they kept not good tongues in their heads’. ‘But in the mean time,’ Eglisham added, ‘the King’s body and head swelled above measure, his hair with the skin of his head stuck to the pillow, his nails became loose upon his fingers and toes’ – signs, perhaps, of poisoning by white arsenic or sublimate of mercury, substances implicated in another courtly scandal fresh in the public mind, the murder of Sir Thomas Overbury in 1613. As to the source of the poison, Eglisham’s finger pointed straight at Buckingham’s astrologer, ‘Dr’ John Lambe. Lambe had become a figure almost as hated as his master, accused of performing ‘diabolical and execrable arts called Witchcrafts, Enchantments, Charmers and Sorcerers’, and in 1623 of raping an eleven-year-old girl. He also practised medicine, which in 1627 led to him being referred to the College of Physicians by the Bishop of Durham.

(#litres_trial_promo)

The poisoning allegations were ignored by the new king and his ministers, but taken up by a number of the Duke’s enemies in Parliament. Relations between Charles and Parliament soured within weeks of his accession, as the matter of his subsidy, the amount of tax revenue to be paid into the royal exchequer, was debated. Villiers’ influence over the new king became one of the main points of contention, and it soon emerged that a number of MPs were planning to bring charges against the Duke for his role in instigating a number of extravagant and disastrous policies. The primary role of Parliament was supposed to be debating laws and raising taxes, not sitting in judgement over the court, and the King was outraged by its presumption.

Meanwhile, a terrible epidemic of the plague had broken out in London, forcing the King to take refuge at Hampton Court. Charles wanted Parliament to continue sitting, to ensure it voted the subsidy he desperately needed, so he forced both houses to reconvene in Oxford – a precursor of the government in exile that Charles set up during the Civil War. The reassembled MPs were in no mood to be compliant, and after an angry debate one of them, Sir George Goring, demanded that Villiers be summoned ‘to clear himself’ – in other words, account for the policies he had advised the King to adopt. This produced a furious response from Charles. He summoned his Council and, according to the snippets picked up by the Venetian ambassador, told his ministers he could not tolerate his ‘servants to be molested’ in this manner. ‘All deliberations were made by his command and consent, notably convoking Parliament; he exculpated the Duke of Buckingham; complained that Parliament had wished to touch his own sovereignty; his condition would be too miserable if he could not command and be obeyed.’ These complaints, made within six months of his succession, would set the tone of his entire reign.

(#litres_trial_promo)

Parliament, however, continued to touch the King’s sovereignty, which became increasingly tender. In the spring of 1626, as Charles still impatiently awaited a settlement on his subsidy, the Commons passed a motion that it would ‘proceed in the business in hand concerning the Duke of Buckingham, forenoon and afternoon, setting all other businesses aside till that be done’. As part of this business, a select committee was appointed to hear the evidence that the Duke had poisoned James.

Only a garbled account of the proceedings survives.

(#litres_trial_promo) Several, but not all, of the King’s physicians were called to give evidence. Craig was notably absent, as was Sir William Paddy, the most senior member of the College to have attended the King, and Sir Theodore de Mayerne, James’s principal physician, who had been abroad since 1624. Those who did attend include Dr Alexander Ramsay, one of James’s Scottish doctors; Dr John Moore, a licentiate of the College (i.e. granted a licence to practise) but never admitted as a Fellow because he was publicly identified as a Catholic; Dr Henry Atkins, the current President of the College; Dr David Beton, another Scottish physician; a Dr Chambers, a ‘sworn’ royal physician but not a Fellow of the College; Dr Edward Lister, a veteran of the College and a Censor at the time of Harvey’s admission; and William Harvey. The King’s surgeon Hayes was also called, together with Thomas Howard, Earl of Arundel, a courtier who was in attendance throughout most of the King’s illness.

All agreed that the Duke had persuaded the King to take a medicine in the form of a posset and a plaster. They also admitted that, soon after the King’s death, they had been asked to endorse a ‘bill’ that was purported to contain the recipe for that medicine. Thereafter, confusion and obfuscation abounded. No one could recall what was in the bill presented to them after the King’s death, or confirm that the recipe was for the medicine given to the King, which implied that they did not know what was in the medicine. Various justifications were offered as to why they allowed an unknown substance to be given to a patient under their care: that they were absent when it was administered, that the King had ordered it to be administered, that they believed it to be safe because it smelt of a theriac or ‘treacle’, specifically Mithridate, an elaborate but familiar medicinal compound which, the doctors reassured the committee, would not have caused any harm in this case.

As to who prepared the medicine, there was little agreement. Some said it was the Duke himself, some that it was the King’s apothecary, one Woolfe. When asked who had been present when the medicine was given, fingers started pointing in many directions, but mostly towards the royal surgeon, Hayes, and the physician in closest attendance at the crucial stages of the King’s illness, William Harvey.

Dr Moore claimed that Harvey had been in attendance when the plaster was first brought in and should have prevented it from being applied. Moore had been identified from the beginning of the inquiry as a Catholic and, as Dr Atkins put it, ‘not sworn’, in other words not officially recognized as a royal physician. He was also forced to admit that it was he who presented the physicians with the supposed recipe for the medicine for their endorsement after the King’s death. This made him more vulnerable than any of the other doctors, and probably explains why he tried to deflect blame in the direction of Harvey.

(#litres_trial_promo)

Harvey, however, was serene. He admitted to being present when the plaster was applied, the surgeon Hayes performing the operation. He ‘gave way’ to the procedure because it was ‘commended by [the] Duke as good for [the King]’. Furthermore, since it was an external treatment, he could safely monitor its effects from the King’s bedside. Trying to spread the responsibility a little, he pointed out that Dr Lister had been there at the time the plaster was first applied, a claim Dr Lister later denied. As for the posset, Harvey had allowed it to be administered as ‘the King desired it, because the Duke and [Earl of] Warwick had used it’. The select committee notes also add the words ‘He commended the posset’, though whether the commendation was Harvey’s or the King’s is unclear. Harvey confirmed that a recipe had been presented to the physicians soon after James’s death, brought in by Sir William Paddy. However, alone of all the physicians questioned, he suggested that the physicians had ‘approved’ it. Unlike some of his colleagues, Harvey appears not to have questioned whether the recipe was the same as that used to make the medicine. As to its origin, all he would say was that it was a ‘secret of a man of Essex’, referring to a John Remington of Dunmow.

(#litres_trial_promo)

The question that remained unanswered throughout the proceedings was why a plaster should have been applied at all. Harvey gave a hint – not to the parliamentary select committee, but to Bishop Williams, the Lord Keeper of the Great Seal, when the two met on the road from London to Theobalds on the Tuesday before the King’s death. Williams later recalled Harvey describing the illness suffered by the King in these terms: ‘That the King used to have a Beneficial Evacuation of Nature, a sweating in his left Arm, as helpful to him as any Fontanel could be; which of late had failed.’ In other words, there was an area probably around the upper left ribs, where he would sweat copiously, allowing the release of surplus humours that would otherwise accumulate and putrefy in that part of the body. This outlet, Harvey claimed, had become blocked, causing a dangerous build-up of those humours. It was a puzzling diagnosis, as James’s underarm fontanel is mentioned nowhere else. Theodore de Mayerne left detailed medical notes on his patient which record, for example, that the King ‘often swells out with wind’ and suffered from legs ‘not strong enough to sustain the weight of the body’; but the only ‘Beneficial Evacuation’ Mayerne mentions was the King’s almost daily ‘haemorrhoidal flow’, which, if blocked, made him ‘very irascible, melancholy, jaundiced’.

(#litres_trial_promo)

Williams, too, was puzzled by Harvey’s diagnosis. ‘This symptom of the King’s weakness I never heard from any else,’ he commented, ‘yet I believed it upon so learned a Doctor’s observation.’ He even attempted to deduce his own theory on how the disease developed, suggesting that the ‘ague’ had become ‘Mortal’ because the infection or ‘Spring’ had entered so far that it had been able ‘to make a commotion in the Humours of the Body’ that could no longer be expelled with ‘accustomed vapouration’.

(#litres_trial_promo) It would also explain why a hot plaster applied to the King’s stomach might help, for, by provoking sweat, or even blisters, it might encourage ‘vapouration’ of the offending humours and so restore the body to a state of healthy balance.

The effect of Harvey’s testimony to the select committee and to Bishop Williams was to deflate the poisoning case. It did not exonerate the Duke, nor did it reveal the all-important recipe for the medicine; but it strongly suggested that Villiers’ intervention was no more than inconvenient, and that it had been insisted upon by James himself, who was an exasperating patient (one fact upon which nearly everyone seemed to agree). The King, Harvey told the select committee, ‘took divers things’ regardless of his medical team’s advice, on account of his ‘undervaluing physicians’.

In its report to the House of Commons, the select committee concluded that ‘when the King [was] in declination’, the Duke had ‘made [the posset and plaster] be applied and given, whereupon great distempers and evil symptoms appeared, and physicians did after advise Duke to do so no more, which is by us resolved a transcendent presumption of dangerous consequence’. On the basis of this, it resolved that the charges should be annexed to the others levelled against the Duke.

When the report was presented to the House, Sir Richard Weston, Charles’s Chancellor of the Exchequer, led a rearguard action on the King’s behalf to defend the Duke, claiming that there was no evidence of a crime being committed. Despite this intervention, the MPs backed the select committee’s report and added the charge to their list of grievances.

But Charles would not sacrifice Villiers. Days after his submission to the select committee, the King sent the Earl of Arundel to the Tower of London. His pretext was that the Earl had allowed his son to marry a royal ward, but everyone knew it was for supporting the anti-Buckingham faction in the House of Lords. After repeated commands to the Commons to drop the charges, Charles eventually dissolved Parliament, thus bringing the impeachment proceedings to a peremptory close. He still did not have the subsidy he needed, at a time when he was having to pay for a disastrous military adventure launched by Villiers against Spain. Facing bankruptcy, he turned over royal lands to the value of around £350,000 to the City in return for the liquidation of his debts, which amounted to £230,000. He also decided to impose a ‘forced loan’, the menacing term for an interest-free, non-refundable levy extracted from taxpayers, claimed as a royal prerogative at times of national emergency. Charles’s predecessors had used this technique, but the levies had generally been small, few had to pay, and many were let off – William Harvey, for example, had managed to avoid a loan of £6. 13s. 4d. imposed by James I in 1604 when a group of influential friends petitioned on his behalf.

(#litres_trial_promo) This time, all rateable taxpayers were expected to contribute, and five separate payments were demanded. A series of high-profile protests resulted. Seventy-six members of the gentry were imprisoned and several peers were dismissed from their offices for refusing to pay. Pondering on the ancient common-law principle of habeas corpus, judges considered whether the royal prerogative extended to imprisoning without charge individuals who represented no threat to national safety; but they could not bring themselves to rule definitively on such a sensitive matter.

The poisoning charges against Villiers were lost in the midst of these epic struggles, and became irrelevant when John Felton, a naval lieutenant, stabbed the Duke to death at Portsmouth in 1628. As to the truth of the charges, they were widely believed at the time, and historians have debated the matter ever since, on the basis of evidence that can never be decisive. Villiers was probably capable of hatching such a plot, and Charles, who had suffered many humiliations at the hands of his father and who was impatient to take the reins of government, may even have connived. But James was already ill before the Duke’s interventions. In addition to malaria, he was suffering from a variety of chronic ailments, including gout and possibly the royal malady porphyria (the ‘madness’ of King George III, a non-fatal but debilitating intermittent disease that got its name from the Greek for purple, the colour of the sufferer’s urine). Poisoning is one possible reason why a condition originally considered to be non-threatening turned lethal, but there are plenty of others.

No censures were brought against the physicians. They could have been accused of negligence, but the committee was only interested in attacking Villiers and seemed to accept the difficulties of managing a royal patient. However, the episode left a mark on their profession, barely noticeable in the mid-1620s but soon to become as obvious to its enemies as the most unsightly wart. In 1624, an Oxford scholar called John Gee had published The Foot out of the Snare, a list of all Catholics known or suspected of living in London. In addition to naming priests and ‘Jesuits’, it had a section devoted entirely to ‘Popish Physicians now practising about London’. Dr Moore was the first to be listed, but there were many others, including Thomas Cadyman, Robert Fludd, John Giffard, and Francis Prujean, all of them prominent members of the College. Many had, Gee pointed out, been to ‘Popish Universities beyond the seas’ such as Padua, ‘and it is vehemently suspected that some of these have a private faculty and power from the See of Rome’ to administer the last rites to their patients. Harvey was not among those listed, and never would be. Though disliking Puritans, he steered clear of religious controversy. Protestants in Parliament, however, demanded, in 1626 and again in 1628, that the College identify any practising physicians who were ‘recusant’ (Catholics who refused to attend Anglican services). Lists were duly drawn up that identified Moore and Cadyman among others. No action was taken against them, either by Parliament or by the College. Many, in particular Prujean, went on to prosper; but the poisoning episode served to reinforce further the feeling among some Protestant radicals that the College had the same papist leanings and corrupt attitudes as the court it served.

(#litres_trial_promo)

William Harvey came out best from the whole controversy. Within a few weeks of the select committee inquiry drawing to a close he received a ‘free gift’ of £100 from Charles I ‘for his pains and attendance about the person of his Majesty’s late dear father, of happy memory, in time of his sickness’. There is also a reference among the College’s papers to Harvey receiving a ‘general pardon’ from Charles in early 1627, at the time when the parliamentary impeachment of Villiers was launched. The pardon appears to have been designed to provide retrospective immunity from any charges relating to Harvey’s time as one of James’s physicians. Such immunity was not routinely provided to royal physicians, so the fact that it was granted suggests a specific charge was anticipated – for example that Harvey was somehow complicit in James’s death.

(#litres_trial_promo) Whatever the significance of the new king’s generosity, it confirmed Harvey’s special position at Charles’s side, where he would remain the most loyal and devoted of royal servants, unshakeable in his attachment to the King during one of the roughest reigns in English history.

A visitation of plague to London as depicted in Thomas Dekker’s A Rod for Run-Aways, 1625.

In the summer months of 1625, while Parliament and the court were at Oxford debating Buckingham’s impeachment, the scholar and poet John Taylor chaperoned Queen Henrietta Maria, just arrived from France, on a trip up the Thames from Hampton Court to Oxford. Gliding on the royal barge through the lush countryside, past Runnymede, where the Magna Carta was signed, and the towers of Windsor Castle, the royal party found the gentle pleasures of a summer cruise transformed into a ‘miserable & cold entertainment’. Crowds of starving, homeless people lined the banks. They were Londoners, desperately trying to escape one of the deadliest outbreaks of the plague in the city’s history – at least as severe as the more famous Great Plague of 1665. Having reached the country, these refugees had faced what Taylor described as a ‘bitter wormwood welcome’ from the country folk. Greeted as wealthy tourists in better times, they were shunned for fear that they carried the contagion. ‘For a man to say that he came from Hell would yield him better welcome without money, than one would give to his own father and mother that come from London,’ Taylor observed.

(#litres_trial_promo)

Back in London, a stray visitor would not at first have beheld the apocalypse, just empty streets deodorized with oak and juniper smoke, musket fumes, rosemary garlands and frankincense, and peals of bells. They would pass dormant houses, the staring eyes of their inhabitants glimpsed through windows thrown open to let in the fragranced air and the clarions. They would spot stray dogs who had lost their masters, ditches left undredged for fear of stirring up pestilential airs, lone pedestrians chewing angelica or gentian or wearing arsenic amulets to ward off infection, some coming to a sudden halt and holding out their arms in curious positions, as though carrying invisible pails of water – signs of the first twinges of the characteristic plague sores or ‘buboes’ that appear under the arms.

(#litres_trial_promo)